| NPI | 1306392089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 0003495) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 0003495) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2019-05-22 |